Dr. Govinda KC Hunger Strike

DR JEEVAN CHHETRI AND NIKUNJ BHANDARI WELCOME!

Interviewer: Shows a photo from twitter. Dr. K.C has done hunger strike at least 2 times at Sushil Koirala's leadership and 3 times around mass movement, the dialogues with government are waiting for implementation why is his demand postponed?

DR.Jeevan: The main reason is the agreement done with the government; the reason behind it is not for implementation but release hold of Dr. K.C'S demand and come out of difficult situation so that the pressure can be minimized is the main factor. Context of not working honestly but going reverse of the agreement and non-implementation part with Dr.K.C's demand, vested interest of people affecting to the implementation of all the bodies under political influence is another factor.

Interviewer: 11 times, isn't it more than enough?
Dr. Jeevan: The nation didn’t keep Dr K.C’s demand in the law. So, Dr.K.C’s hunger strike would not be for so long time. His agenda starting from appointment of Dean to the latest taking medical institution under the regulation of law, the progressive steps must also be considered.

Interviewer: Why has it not been effectively implemented?
Nikunj Bhandari: Dr. K.C's demand is very valid. In depths we understand that it might be benefiting certain groups’ people who are protesting it.
Dr. Jeevan: On Nikunj's article there are some points highlighted such as if we stop new medical colleges then old medical college curtailing might fade out the competitive factor. Dr.K.C views on new medical colleges and centralization in Kathmandu only is not the issue. We should adopt decentralization as there is overcrowding of colleges here. In general, under Kedar Bhakta Mathema's overview, one district not more than one medical college, it is time for decentralization.

NIKUNJ BHANDARI: We see the trend of where the students are? If they are coming from outside to Kathmandu then we must seek for solution. The medical colleges which are trying to establish outside what do they need? We should assess it in terms of infrastructure. Government shouldn't force on this issue but it should be done willingly. From student’s perspective are they willing to stay or not, market is there or not should be monitored. Huge investments in medical college are not just only for seeking social service. We need to know the reasons to find out on what basis should we send medical colleges outside must be prioritized.

Interviewer: During 11 times hunger strike of Dr. Govinda K.C , how are we able to implement Dr K.C'S demands?
Dr. Jeevan. On implementation issues if we have the Medical Institute Act .They will streamline the implementation aspects. Outside Kathmandu is it feasible or not to open medical college is key issue. Past experience say from government body lIke B.P.Koirala Medical institute at Dharan and few private .medical college coming to Kathmandu despite investors motives, government body sent there reach and acted as catalyst for overall development. They carried out very nice role in places like Dang, Dhangadi as service and not just medical field and it is feasible. The blind spot must be guided by the government.

Interviewer: Mahesh Bhandari from Pokhara says “Sorry I am not with Dr. K.C, What made him think like that?
Dr. Jeewan: I don't know the basis of his statement. Personally, the crisis in management at most government and private sector rises due to lack of good governance. Skeptical people have thought private sector must be banned and corruption in medical education results in no sustainable progress and Dr.K.C's longer protests have often left people frustrated.

Interviewer: In fee structures of medical colleges the mafias still instigated corruption from internal level what are your views?
Nikunj Bhandari: In Nepal, the implementation bureau is conducting the range seeking; defining law as per self needs and other part going are outside law like lobbying. Private sector is not very pure and crystal clear. They are working for their own interest. So, how clear is our governance and how well implemented is our law. This is not about people's dictatorship instead comes from regulatory body of law. The sheep mentality tendency where everybody follows one person is seen. If more people wants to enter in limited seats they have to invest more (35 lakhs) or move to foreign country, no alternatives left. If it is seen from Dr.K.Cs vision it will run as an autonomous body and there is chance of free competition and medical sector along with other education sector flourish together.

Dr. Jeevan: As said by Nikunj, why not let competition do the work, medical sector is different from other sector because of lack of regulation in corruption over quotas. If you don’t allow open competition the inequality in our society, the high fees itself is an obstruction for major people to come in this field. Fewer fees means more accessibility of people. In fair competition the obstruction is that unlike other business where begins and small looses, in our context; by the time one batch passes out he already has six batches of students with him. In six batches, if one medical does bad performance then managing 400-500 students’ adjustment like the Janaki medical college is facing a big problem. In present context, with lot of criteria’s of autonomy, decentralization and against lobbying we can move to a secured spot.

Nikunj Bhandari: At national level ,entrance test filters and competition allows to pulls new students. If he/ she is deserving they opt for medical studies. Managing problems of Janaki Medical College the state should have policy of entering and leaving. If you move out you have to fulfill certain criteria like liquidation of company. Students should not be impacted in any ways. There should be safeguards in the system and government might face issues but after tackling them it will be worth it. Lobbyist and rent seekers are pressurizing so much that we need transparent policy. In autonomous entity for guaranteed functioning, the govt. body must be established. Corruption has made the system stagnant between two way relationship of medical college mafias and politicians. Dr.K.C's objectives are very good.

Dr.Jeevan :There should have been lots of debate and discussions over "Seto Pati" article on policy level. The nation should address rigorously over the agreement with Dr K.C's demand. Done in a superficial level, now we should bury the loopholes and work on content issues and governance to avoid pitfalls of corruptions.
Interviewer: Private medical college charge high fees and run more than Government College in ratio is this is a money making vehicle only?

Nikunj Bhandari: In totality, health is not business centered. We must be prepared and government should invest on patients than the middlemen. Government hospitals will not earn without work like "Money follows the patient" policy of Ireland. Only after treatment the grant is given from the government. Latest analysis shows the operation fees is decreasing in Ireland. Technical facilities are provided. Nepal should adopt certain standards like medical insurance for lower groups of people. In short run, nonprofit sector can be included to run hospital sector like tilganga and remove tax evasion entirely.
Interviewer: You are in dialogue for 11 times what are your expectations from the outcome?

Dr. Jeewan: This time our biggest expectation are at different rounds of agreement with government in heath sector diversification and quality improvement of medical sector, in the Act, if we can incorporate this it is a major initiative for us to bury the loopholes, our debate is hooked to this point. We are not working for any party or political people but for promotion of merit based admission and development on fairness, we are making the demand more concise.
Nikunj Bhandari: I hope next time Dr .Govinda K.C never go for a hunger strike. Secondly, the medical council bring all the issues to forefront for facilitation for people at remote areas like Manang. In the policy level, the distortion factors between governance and law of the nation must be removed for clarity.